A Laboratory Phenotype/Genotype Correlation of 1167 French Patients From 670 Families With von Willebrand Disease: A New Epidemiologic Picture

von Willebrand disease (VWD) is a genetic bleeding disease due to a defect of von Willebrand factor (VWF), a glycoprotein crucial for platelet adhesion to the subendothelium after vascular injury. VWD include quantitative defects of VWF, either partial (type 1 with VWF levels 

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Veröffentlicht in:Medicine (Baltimore) 2016-03, Vol.95 (11), p.e3038-e3038
Hauptverfasser: Veyradier, Agnès, Boisseau, Pierre, Fressinaud, Edith, Caron, Claudine, Ternisien, Catherine, Giraud, Mathilde, Zawadzki, Christophe, Trossaert, Marc, Itzhar-Baïkian, Nathalie, Dreyfus, Marie, d'Oiron, Roseline, Borel-Derlon, Annie, Susen, Sophie, Bezieau, Stéphane, Denis, Cécile V, Goudemand, Jenny
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container_issue 11
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container_title Medicine (Baltimore)
container_volume 95
creator Veyradier, Agnès
Boisseau, Pierre
Fressinaud, Edith
Caron, Claudine
Ternisien, Catherine
Giraud, Mathilde
Zawadzki, Christophe
Trossaert, Marc
Itzhar-Baïkian, Nathalie
Dreyfus, Marie
d'Oiron, Roseline
Borel-Derlon, Annie
Susen, Sophie
Bezieau, Stéphane
Denis, Cécile V
Goudemand, Jenny
description von Willebrand disease (VWD) is a genetic bleeding disease due to a defect of von Willebrand factor (VWF), a glycoprotein crucial for platelet adhesion to the subendothelium after vascular injury. VWD include quantitative defects of VWF, either partial (type 1 with VWF levels 
doi_str_mv 10.1097/MD.0000000000003038
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VWD include quantitative defects of VWF, either partial (type 1 with VWF levels &lt;50 IU/dL) or virtually total (type 3 with undetectable VWF levels) and also qualitative defects of VWF (type 2 variants with discrepant antigenic and functional VWF levels). The most bleeding forms of VWD usually do not concern type 1 patients with the mildest VWF defects (VWF levels between 30 and 50 IU/dL). The French reference center for VWD performed a laboratory phenotypic and genotypic analysis in 1167 VWD patients (670 families) selected by their basic biologic phenotype: type 3, type 2, and type 1 with VWF levels &lt;30 IU/dL. In these patients indeed, to achieve an accurate diagnosis of VWD type and subtype is crucial for the management (treatment and genetic counseling). A phenotype/genotype correlation was present in 99.3% of cases; 323 distinct VWF sequence variations (58% of novel) were identified (missense 67% versus truncating 33%). The distribution of VWD types was: 25% of type 1, 8% of type 3, 66% of type 2 (2A: 18%, 2B: 17%, 2M: 19%, 2N: 12%), and 1% of undetermined type. Type 1 VWD was related either to a defective synthesis/secretion or to an accelerated clearance of VWF. In type 3 VWD, bi-allelic mutations of VWF were found in almost all patients. In type 2A, the most frequent mechanism was a hyper-proteolysis of VWF. Type 2B showed 85% of patients with deleterious mutations (distinct from type 2B New York). Type 2M was linked to a defective binding of VWF to platelet glycoprotein Ib or to collagen. Type 2N VWD included almost half type 2N/3. This biologic study emphasizes the complex mechanisms for both quantitative and qualitative VWF defects in VWD. In addition, this study provides a new epidemiologic picture of the most bleeding forms of VWD in which qualitative defects are predominant.</description><identifier>ISSN: 0025-7974</identifier><identifier>EISSN: 1536-5964</identifier><identifier>DOI: 10.1097/MD.0000000000003038</identifier><identifier>PMID: 26986123</identifier><language>eng</language><publisher>United States: Wolters Kluwer Health</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Female ; France - epidemiology ; Genotype ; Humans ; Infant ; Male ; Middle Aged ; Mutation ; Observational Study ; Phenotype ; von Willebrand Diseases - epidemiology ; von Willebrand Diseases - genetics ; Young Adult</subject><ispartof>Medicine (Baltimore), 2016-03, Vol.95 (11), p.e3038-e3038</ispartof><rights>Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved. 2016</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c225t-318bb076b049dc3f6be628a40da7613842d89845b5baa37b5d9091044b4ec4cc3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4839904/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4839904/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26986123$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Veyradier, Agnès</creatorcontrib><creatorcontrib>Boisseau, Pierre</creatorcontrib><creatorcontrib>Fressinaud, Edith</creatorcontrib><creatorcontrib>Caron, Claudine</creatorcontrib><creatorcontrib>Ternisien, Catherine</creatorcontrib><creatorcontrib>Giraud, Mathilde</creatorcontrib><creatorcontrib>Zawadzki, Christophe</creatorcontrib><creatorcontrib>Trossaert, Marc</creatorcontrib><creatorcontrib>Itzhar-Baïkian, Nathalie</creatorcontrib><creatorcontrib>Dreyfus, Marie</creatorcontrib><creatorcontrib>d'Oiron, Roseline</creatorcontrib><creatorcontrib>Borel-Derlon, Annie</creatorcontrib><creatorcontrib>Susen, Sophie</creatorcontrib><creatorcontrib>Bezieau, Stéphane</creatorcontrib><creatorcontrib>Denis, Cécile V</creatorcontrib><creatorcontrib>Goudemand, Jenny</creatorcontrib><creatorcontrib>French Reference Center for von Willebrand disease</creatorcontrib><title>A Laboratory Phenotype/Genotype Correlation of 1167 French Patients From 670 Families With von Willebrand Disease: A New Epidemiologic Picture</title><title>Medicine (Baltimore)</title><addtitle>Medicine (Baltimore)</addtitle><description>von Willebrand disease (VWD) is a genetic bleeding disease due to a defect of von Willebrand factor (VWF), a glycoprotein crucial for platelet adhesion to the subendothelium after vascular injury. VWD include quantitative defects of VWF, either partial (type 1 with VWF levels &lt;50 IU/dL) or virtually total (type 3 with undetectable VWF levels) and also qualitative defects of VWF (type 2 variants with discrepant antigenic and functional VWF levels). The most bleeding forms of VWD usually do not concern type 1 patients with the mildest VWF defects (VWF levels between 30 and 50 IU/dL). The French reference center for VWD performed a laboratory phenotypic and genotypic analysis in 1167 VWD patients (670 families) selected by their basic biologic phenotype: type 3, type 2, and type 1 with VWF levels &lt;30 IU/dL. In these patients indeed, to achieve an accurate diagnosis of VWD type and subtype is crucial for the management (treatment and genetic counseling). A phenotype/genotype correlation was present in 99.3% of cases; 323 distinct VWF sequence variations (58% of novel) were identified (missense 67% versus truncating 33%). The distribution of VWD types was: 25% of type 1, 8% of type 3, 66% of type 2 (2A: 18%, 2B: 17%, 2M: 19%, 2N: 12%), and 1% of undetermined type. Type 1 VWD was related either to a defective synthesis/secretion or to an accelerated clearance of VWF. In type 3 VWD, bi-allelic mutations of VWF were found in almost all patients. In type 2A, the most frequent mechanism was a hyper-proteolysis of VWF. Type 2B showed 85% of patients with deleterious mutations (distinct from type 2B New York). Type 2M was linked to a defective binding of VWF to platelet glycoprotein Ib or to collagen. Type 2N VWD included almost half type 2N/3. This biologic study emphasizes the complex mechanisms for both quantitative and qualitative VWF defects in VWD. In addition, this study provides a new epidemiologic picture of the most bleeding forms of VWD in which qualitative defects are predominant.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Female</subject><subject>France - epidemiology</subject><subject>Genotype</subject><subject>Humans</subject><subject>Infant</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Mutation</subject><subject>Observational Study</subject><subject>Phenotype</subject><subject>von Willebrand Diseases - epidemiology</subject><subject>von Willebrand Diseases - genetics</subject><subject>Young Adult</subject><issn>0025-7974</issn><issn>1536-5964</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdUU1vEzEQtRCIpoVfgIR85LKtv9Zec0CKkqZFSiGHVj1atnfSGHnXwd4U5U_wm7tV06owl_l8b2b0EPpEySklWp1dzU_JK-OEN2_QhNZcVrWW4i2aEMLqSmkljtBxKb8IoVwx8R4dMakbSRmfoL9TvLQuZTukvMerDfRp2G_h7OIQ4FnKGaIdQupxWmNKpcKLDL3f4NVYhX4oY546LBXBC9uFGKDg2zBs8P0IuQ0xgsu2b_E8FLAFvuIp_gF_8Pk2tNCFFNNd8HgV_LDL8AG9W9tY4OPBn6Cbxfn17LJa_rz4PpsuK89YPVScNs4RJR0RuvV8LR1I1lhBWqsk5Y1gbaMbUbvaWcuVq1tNNCVCOAFeeM9P0Lcn3u3OddD68Y1so9nm0Nm8N8kG82-nDxtzl-6NaLjWRIwEXw4EOf3eQRlMF4qHGG0PaVcMVUrUnFD2OMqfRn1OpWRYv6yhxDwqaa7m5n8lR9Tn1xe-YJ6l4w8zAJoV</recordid><startdate>201603</startdate><enddate>201603</enddate><creator>Veyradier, Agnès</creator><creator>Boisseau, Pierre</creator><creator>Fressinaud, Edith</creator><creator>Caron, Claudine</creator><creator>Ternisien, Catherine</creator><creator>Giraud, Mathilde</creator><creator>Zawadzki, Christophe</creator><creator>Trossaert, Marc</creator><creator>Itzhar-Baïkian, Nathalie</creator><creator>Dreyfus, Marie</creator><creator>d'Oiron, Roseline</creator><creator>Borel-Derlon, Annie</creator><creator>Susen, Sophie</creator><creator>Bezieau, Stéphane</creator><creator>Denis, Cécile V</creator><creator>Goudemand, Jenny</creator><general>Wolters Kluwer Health</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>201603</creationdate><title>A Laboratory Phenotype/Genotype Correlation of 1167 French Patients From 670 Families With von Willebrand Disease: A New Epidemiologic Picture</title><author>Veyradier, Agnès ; 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VWD include quantitative defects of VWF, either partial (type 1 with VWF levels &lt;50 IU/dL) or virtually total (type 3 with undetectable VWF levels) and also qualitative defects of VWF (type 2 variants with discrepant antigenic and functional VWF levels). The most bleeding forms of VWD usually do not concern type 1 patients with the mildest VWF defects (VWF levels between 30 and 50 IU/dL). The French reference center for VWD performed a laboratory phenotypic and genotypic analysis in 1167 VWD patients (670 families) selected by their basic biologic phenotype: type 3, type 2, and type 1 with VWF levels &lt;30 IU/dL. In these patients indeed, to achieve an accurate diagnosis of VWD type and subtype is crucial for the management (treatment and genetic counseling). A phenotype/genotype correlation was present in 99.3% of cases; 323 distinct VWF sequence variations (58% of novel) were identified (missense 67% versus truncating 33%). The distribution of VWD types was: 25% of type 1, 8% of type 3, 66% of type 2 (2A: 18%, 2B: 17%, 2M: 19%, 2N: 12%), and 1% of undetermined type. Type 1 VWD was related either to a defective synthesis/secretion or to an accelerated clearance of VWF. In type 3 VWD, bi-allelic mutations of VWF were found in almost all patients. In type 2A, the most frequent mechanism was a hyper-proteolysis of VWF. Type 2B showed 85% of patients with deleterious mutations (distinct from type 2B New York). Type 2M was linked to a defective binding of VWF to platelet glycoprotein Ib or to collagen. Type 2N VWD included almost half type 2N/3. This biologic study emphasizes the complex mechanisms for both quantitative and qualitative VWF defects in VWD. In addition, this study provides a new epidemiologic picture of the most bleeding forms of VWD in which qualitative defects are predominant.</abstract><cop>United States</cop><pub>Wolters Kluwer Health</pub><pmid>26986123</pmid><doi>10.1097/MD.0000000000003038</doi><oa>free_for_read</oa></addata></record>
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subjects Adolescent
Adult
Aged
Aged, 80 and over
Child
Child, Preschool
Female
France - epidemiology
Genotype
Humans
Infant
Male
Middle Aged
Mutation
Observational Study
Phenotype
von Willebrand Diseases - epidemiology
von Willebrand Diseases - genetics
Young Adult
title A Laboratory Phenotype/Genotype Correlation of 1167 French Patients From 670 Families With von Willebrand Disease: A New Epidemiologic Picture
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